All information should be typed in upper and lower case (eg: Mary Smith).
On completion of the form, click on the "Submit Registration" button at the end of this form.
Depending on your selected Payment Method you will be given different options.
Receipt of payment will be forwarded with confirmation of registration.

Personal Information

On Waiting List


First Name

Title (Mr/Mrs/Ms/Dr/Prof)



Postal Address


Daytime Telephone

Format: NZ = 01 234 5678, International = +_ _ 1 234 5678

Home Telephone

  as above

Mobile Phone

  as above


Special Requirements

Dietary: please describe
Mobility: please describe
Other:  please describe
Preferred Name Badge First Name:    Last Name: 

Privacy Act

The Privacy Act (NZ) 1993 states that, before your name and address details can be published in the list of delegates, either for distribution to fellow delegates or any other party, you must give your consent.

If you do not wish your name, address and details to be included in the list of delegates or provided for use by the conference major sponsors, please tick this box.

Conference Fees

Late Registration
From 1 July 2007

Conference Registration
Fee includes all refreshments, lunch, and the conference Dinner

Payment Method
Credit Card online
Pay by Cheque